| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $88 | $139 | $190 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $95 | $95 | $95 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $69 | $109 | $149 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $84 | $84 | $84 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $62 | $62 | $62 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $80 | $127 | $174 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $126 | $126 | $126 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $129 | $145 | $162 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $146 | $202 | $258 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $211 | $211 | $211 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $187 | $187 | $187 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $352 | $352 | $352 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $179 | $255 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $309 | $309 | $309 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $96 | $132 | $168 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $57 | $78 | $100 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $7 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $118 | $176 | $233 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $94 | $100 | $106 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $147 | $200 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $173 | $173 | $173 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $251 | $251 | $251 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $4 | $4 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $8 | $8 | $8 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $40 | $56 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $52 | $52 | $52 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $13 | $14 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $6 | $22 | $38 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $69 | $74 | $79 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $614 | $614 | $614 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $20 | $20 | $20 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $228 | $228 | $228 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $177 | $177 | $177 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $693 | $693 | $693 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $384 | $384 | $384 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $160 | $223 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $429 | $429 | $429 |
| Septoplasty CPT 30520 • ENT | $976 | $976 | $976 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $215 | $215 | $215 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $101 | $101 | $101 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $392 | $392 | $392 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $637 | $637 | $637 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $509 | $509 | $509 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $283 | $283 | $283 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $417 | $417 | $417 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $596 | $596 | $596 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $293 | $293 | $293 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $451 | $451 | $451 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $469 | $469 | $469 |